(2) Holds valid and current documentation showing successful
completion of a Health Care Provider BLS/CPR; and

(3) Has completed a board approved course of at least six
hours didactic and clinical of either predoctoral dental school or
postgraduate instruction.

(b) A dentist who induces relative analgesia/minimal sedation
and anxiolysis/minimal sedation shall have the following
facilities, properly maintained equipment and appropriate drugs
available during the procedures and during recovery:

(1) An operating room large enough to adequately accommodate
the patient on an operating table or in an operating chair and to
allow an operating team of at least two individuals to freely move
about the patient;

(2) An operating table or chair which permits the patient to
be positioned so the operating team can maintain the patient's
airway, quickly alter the patient's position in an emergency and
provide a firm platform for the administration of basic life
support;

(3) A lighting system which permits evaluation of the
patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway
in the event of a general power failure;

(4) Suction equipment which permits aspiration of the oral and
pharyngeal cavities;

(5) An oxygen delivery system with adequate age appropriate
full face mask and appropriate connectors that is capable of
delivering high flow oxygen to the patient under positive pressure,
together with an adequate backup system;

(6) A nitrous oxide delivery system with a fail-safe mechanism
that will ensure appropriate continuous oxygen delivery and a
scavenger system;

(7) A recovery area that has available oxygen, adequate
lighting, suction and electrical outlets. The recovery area can be
the operating room;

(8) Sphygmomanometer, stethoscope and pulse oximeter;

(9) Emergency drugs as specified by rule;

(10) A defibrillator device; and

(11) All equipment and medication dosages shall be in
accordance with the height and weight and age of the patient being
treated.

(c) Before inducing anxiolysis/minimal sedation, a dentist
shall:

(1) Evaluate the patient by using the ASA Patient Physical
Status Classification of the ASA that the patient is an appropriate
candidate for anxiolysis/minimal sedation; and

(2) Obtain written informed consent from the patient or
patient's guardian for the anesthesia. The obtaining of the
informed consent shall be documented in the patient's record.

(d) The dentist shall monitor and record the patient's
condition or shall use a qualified monitor to monitor and record
the patient's condition. The documented requirements of a
qualified monitor monitoring anxiolysis/minimal sedation cases are
as specified by rule. A Class 2 Permit holder may have no more
than one person under anxiolysis/minimal sedation at the same time.

(e) The patient shall be monitored as follows:

(1) Patients shall have continuous monitoring using pulse
oximetry. The patient's blood pressure, heart rate and respiration
shall be recorded at least once before, during and after the
procedure and these recordings shall be documented in the patient
record. At all times, the patient shall be observed by a qualified
monitor until discharge criteria have been met. If the dentist is
unable to obtain this information, the reasons shall be documented
in the patient's record. The record shall also include
documentation of all medications administered with dosages, time
intervals and route of administration including local anesthesia.

(2) A discharge entry shall be made by the dentist in the
patient's record indicating the patient's condition upon discharge.

(f) A permit holder who uses anxiolysis/minimal sedation shall
see that the patient's condition is visually monitored. The
patient shall be monitored as to response to verbal stimulation, oral mucosal color and preoperative and postoperative vital signs.

(g) The dentist shall assess the patient's responsiveness
using preoperative values as normal guidelines and discharge the
patient only when the following criteria are met:

(2) The patient is alert and oriented to person, place and
time as appropriate to age and preoperative neurological status;

(3) The patient can talk and respond coherently to verbal
questioning or to preoperative neurological status;

(4) The patient can sit up unaided or to preoperative
neurological status;

(5) The patient can ambulate with minimal assistance or to
preoperative neurological status; and

(6) The patient does not have uncontrollable nausea or
vomiting and has minimal dizziness.

(h) A dentist may not release a patient who has undergone
anxiolysis/minimal sedation except to the care of a responsible
adult third party.

Note: WV Code updated with legislation passed through the 2014 1st Special Session
The WV Code Online is an unofficial copy of the annotated WV Code, provided as a convenience. It has NOT been edited for publication, and is not in any way official or authoritative.